Understanding Barriers to Mammography Use Among Women of Low Socioeconomic Status: Comparisons from Quantitative and Qualitative Data

Abstract

Because underuse of mammography is more common among older women and women of low socioeconomic status, a study was conducted to elucidate underuse in such a sample. The aims were to compare and contrast women's barriers to mammography use, as reported through quantitative and qualitative data. Complementary approaches were used to confirm and to assess completeness of findings. Participants (n = 101) were 51–80 years old, had not had annual mammograms previously, and were identified through an urban hospital mammography clinic that serves medically indigent clients. External barriers were assessed with items from an established barriers scale, including practitioner, cost, and system factors. Participants were asked open-ended questions about what stood in their way and what would help most in having a mammogram. Responses to the barriers scale revealed transportation and cost difficulties. Responses to the questions about obstacles revealed cost, transportation, scheduling, and motivational difficulties. Responses to the question about facilitators focused on improving practitioner-client interactions about screening. The quantitative responses about barriers were confirmed in part by responses about obstacles. However, difficulties with practitioners were revealed only in responses about facilitators. Both quantitative and qualitative data were useful to elucidate more fully the underuse of mammography screening among these socioeconomically disadvantaged women.